AIM:To observe the clinical features and therapeutic efficacy of congenital esotropia and to follow-up the strabismus changes after surgery and the significance of the early treatment. METHODS: This study added up clinical data of 40 cases with congenital esotropia and made a retrospective analysis for their long-term eye position observation results.RESULTS: In congenital esotropia, postoperatively, the rate of achieving alignment within±10△at the last follow-up was significantly low and binocular vision in the group of surgery before 4 years old was significantly higher than that of after 4 years old.CONCLUSION: When cases with congenital esotropia obtain operation in sensitive period of vision development, the functional recovery is good.